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Factors Affecting Usage Levels and Trends of Innovative Oncology Drugs Upon and After Reimbursement Under Taiwan National Health Insurance: Interrupted Time Series Analysis.

Healthcare expenditure on pharmaceuticals, especially innovative oncology drugs, is escalating. Current knowledge on this topic is largely limited to studies conducted upon reimbursement of new drugs. We investigated how endogenous factors (e.g., changed reimbursement criteria, such as an expanded indication) and exogenous factors (e.g., competing drugs) affect the level and trends of innovative oncology drug utilization in the Taiwan National Health Insurance (NHI) system, both upon reimbursement and afterward. This retrospective longitudinal study analyzed monthly data (January 2009 to Decem

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… Endogenous factors in Taiwan include the NHI reimbursement criteria, which impose various restrictions, such as specifying the indication or population, prior authorization, stepwise therapy, quotas, and suchlike. … Endogenous intervention was defined as changed NHI reimbursement criteria, in four categories: (i) expanded indication; (ii) change from later‐line to earlier‐line therapy; (iii) changed prescribing restriction on prior authorization, stepwise therapy, or quota; and (iv) multiple factors (e.g., changed …

PD-1 Pathway Inhibitors: Immuno-Oncology Agents for Restoring Antitumor Immune Responses.

Immune checkpoint inhibitors are designed to restore a patient's own antitumor immune response that has been suppressed during tumor development. The first monoclonal antibodies against the immune checkpoint programmed death 1 (PD-1) receptor, nivolumab and pembrolizumab, are now approved for clinical use. Both agents are indicated for the treatment of advanced melanoma, as well as for the treatment of metastatic non-small cell lung cancer (NSCLC). Nivolumab is also approved for the treatment of advanced renal cell carcinoma. In patients with melanoma, these agents result in objective response

Patient-reported outcomes following autologous stem cell transplant for patients with multiple myeloma.

We evaluated changes in patient-reported outcomes and cognitive function from pre- to 3-6 months post-treatment among 42 newly diagnosed patients with multiple myeloma undergoing transplant with complete data using PROMIS-29. There were statistically significant improvements in physical (p < .001) and mental health (p < .001) but not cognition from pre-treatment to 3-6 month follow-up. Similar results were seen within age or comorbidity strata. Patients with myeloma undergoing transplant experienced generally improved short-term health outcomes with no significant declines in cognition.

Duloxetine prevents bortezomib and paclitaxel large-fiber chemotherapy-induced peripheral neuropathy (LF-CIPN) in sprague dawley rats.

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating, treatment-limiting, side-effect of several classes of chemotherapy drugs. While negatively impacting oncology patients' quality of life, chemotherapy-induced large-fiber (LF) neuropathy is amongst the least well understood components of CIPN, and one for which there is currently no established therapy. Preliminary clinical observations have led to the suggestion that Duloxetine, which is used for the treatment of pain associated with small-fiber CIPN (SF-CIPN), may be effective against LF-CIPN. In the present experiments we d

Preoperative stereotactic radiosurgery for brain metastases: the STEP study protocol for a multicentre, prospective, phase-II trial.

BackgroundSurgery is an important therapeutic option for brain metastases. Currently, postoperative stereotactic radiosurgery (SRT) leads to 6-month and 1-year local control estimated at 70 and 62% respectively. However, there is an increased risk of radio-necrosis and leptomeningeal relapse. Preoperative SRT might be an alternative, providing local control remains at least equivalent. It is an innovative concept that could enable the stereotactic benefits to be retained with advantages over post-operative SRT.MethodsSTEP has been designed as a national, multicentre, open-label, prospective, n

Seeking American Society of Clinical Oncology-Quality Oncology Practice Initiative (ASCO-QOPI) certification in a northern New England rural health system and cancer care network.

In 2006 following several years of preliminary study, the American Society of Clinical Oncology (ASCO) launched the Quality Oncology Practice Initiative (QOPI). This cancer-focused quality initiative evolved considerably over the next decade-and-a-half and is expanding globally. QOPI is undoubtedly the leading standard-bearer for quality cancer care and contemporary medical oncology practice. The program garners attention and respect among federal programs, private insurers, and medical oncology practices across the nation. The MaineHealth Cancer Care Network (MHCCN) has undergone expansive gr

Short Course of Antibiotic Therapy for Gram-Negative Bacilli Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation: Less Is Possible.

Data about short courses of antibiotic therapy for Gram-negative bacilli (GNB) bacteremia in immunosuppressed patients are limited. This is a prospective observational study performed on adult patients with cancer and hematopoietic stem cell transplant (HSCT) who developed GNB bacteremia and received appropriate empirical antibiotic therapy (EAT), had a clinical response within 7 days and survived 48 h after the end of therapy. They received antibiotic therapy in the range of 7-15 days and were divided into short course, with a median of 7 days (SC), or long course, with a median of 14 days (L

Lenalidomide versus bortezomib maintenance after frontline autologous stem cell transplantation for multiple myeloma.

Lenalidomide (LEN) maintenance (MT) post autologous stem cell transplantation (ASCT) is standard of care in newly diagnosed multiple myeloma (MM) but has not been compared to other agents in clinical trials. We retrospectively compared bortezomib (BTZ; n = 138) or LEN (n = 183) MT from two subsequent GMMG phase III trials. All patients received three cycles of BTZ-based triplet induction and post-ASCT MT. BTZ MT (1.3 mg/m2 i.v.) was administered every 2 weeks for 2 years. LEN MT included two consolidation cycles (25 mg p.o., days 1-21 of 28 day cycles) followed by 10-15 mg/day for 2 years. The

A prospective observational study to assess clinical decision-making, prognosis, quality of life and satisfaction with care in patients with relapsed/refractory multiple myeloma: the CLARITY study protocol.

BACKGROUND: Treatment decision-making in patients with relapsed/refractory multiple myeloma (RRMM) is challenging for a number of reasons including, the heterogeneity of disease at relapse and the number of possible therapeutic approaches. This study broadly aims to generate new evidence-based data to facilitate clinical decision-making in RRMM patients. The primary objective is to investigate the prognostic value of patient self-reported fatigue severity for overall survival. METHODS: This multicenter prospective observational study will consecutively enroll 312 patients with multiple myelom

Longitudinal effects of inpatient music therapy dosage on pain intensity and opioid utilization among patients with hematologic or oncologic conditions: a retrospective cohort study.

PurposeSeveral studies support the benefits of music therapy (MT) for improving symptoms within a single session among patients with hematologic/oncologic conditions, but none have examined real-world longitudinal impacts. This study evaluated whether there was a dose-response relationship between MT intervention exposure and longitudinal changes in pain intensity and opioid utilization.MethodsA retrospective electronic health record review was conducted of 283 hospital admissions among adult patients with hematologic/oncologic conditions who received MT and either reported pain ≥ 4/10 on the

Clinical Posters From JADPRO Live 2024

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Increased survival of cirrhotic patients with septic shock.

IntroductionThe overall outcome of septic shock has been recently improved. We sought to determine whether this survival gain extends to the high-risk subgroup of patients with cirrhosis.MethodsCirrhotic patients with septic shock admitted to a medical intensive care unit (ICU) during two consecutive periods (1997-2004 and 2005-2010) were retrospectively studied.ResultsForty-seven and 42 cirrhotic patients presented with septic shock in 1997-2004 and 2005-2010, respectively. The recent period differed from the previous one by implementation of adjuvant treatments of septic shock including albu

The impact of fluoroquinolone-resistant enterobacterales colonization on fluoroquinolone prophylaxis efficacy in hematopoietic cell transplant recipients.

INTRODUCTION: Hematopoietic cell transplantation (HCT) carries a high infection risk, especially pre-engraftment. Fluoroquinolone (FQ) prophylaxis is common, but rising FQ-resistant Enterobacterales (FQRE) rates may limit its effectiveness. This study evaluated febrile neutropenia, bacteremia, and mortality in HCT patients based on FQ prophylaxis and FQRE colonization. METHODS: A retrospective analysis of HCT recipients at a tertiary center in Lebanon (2017–2022) was performed. Patients receiving FQ prophylaxis during neutropenia were compared with those who did not. FQRE colonization was moni

Ceftazidime-Avibactam Regimens for the Treatment of Bacteremic and Non-Bacteremic Episodes of Carbapenemase-Producing Enterobacterales Infections in Immunosuppressed Patients.

Ceftazidime-avibactam (CA) and CA plus aztreonam (ATM) are the preferred treatment options for KPC and MBL carbapenemase-producing Enterobacterales infections (CPEis). All episodes of monomicrobial CPEis in immunosuppressed patients (IPs) admitted from May 2019 to November 2024, who received definitive antibiotic therapy (AT) with CA or CA + ATM for at least 72 h, were prospectively included. Bacteremic episodes (BEs) and non-bacteremic episodes (NBEs) were compared. Logistic regressions adjusted by propensity score were used to identify variables associated with 30-day overall mortality. In t

Prevalence and effect on survival of pre-treatment sarcopenia in patients with hematological malignancies: a meta-analysis.

Background & aimsEvidence regarding the prevalence of pre-treatment sarcopenia and its impact on survival in patients with hematological malignancies (HM) varies across studies. We conducted a systematic review and meta-analysis to summarize this discrepancy.MethodsPubMed, Embase and Cochrane library were systematically searched for relevant studies. Outcomes assessed were: prevalence of pre-treatment sarcopenia, overall survival (OS), progression-free survival (PFS) and complete response (CR). Weighted mean proportion, odds ratios (ORs) and hazard ratios (HRs) were estimated using a fixed-eff

Инфекционные токсичные вещества, связанные с биконкретными антителами и клетками CAR-T в множестве миеломы: систематический обзор.

Лечение с перенацеливанием клеток изменило лечение повторной/охлажденной множественной миэломы (RRMM), но связано со значительным риском инфицирования. Мы систематически анализировали инфекционные заболевания после терапии Т-клеток CAR и биконкретных антител (BSAbs) с уделением особого внимания частотности, времени, патогенам, факторам риска и профилактике. Следуя руководящим принципам PRISMA, мы обыскали Паббмеда до мая. 22, 2026, и включает исследования, содержащие информацию о инфекционных результатах у пациентов, проходящих курс лечения с помощью клеток CAR-T или BsAbs. Всего 123 Был прове

«Я пропустил своего другого онколога»: сложившиеся отношения как барьеры и посредники в доступе к CAR-T и автономной трансплантации.

: Автологическая трансплантация стволовых клеток (ASCT) и химерика антигенного рецептора Т-клетотерапия (CAR-T) может принести значительные клинические выгоды, но не все пациенты имеют равный доступ к ним. Онкологическая преемственность и доверие имеют важное значение для пациентов и могут служить препятствием для получения лечения. Однако отсутствуют подробные данные о механизме, с помощью которого они могут повлиять на получение лечения, или о том, каким образом этот барьер может быть преодолен. Мы провели качественное исследование с пациентами с неходгкинской лимфомой (NHL), классической Хо

A Systematic Review Evaluating the Impact of Fibre Supplementation on Gut Health and Other Clinical Outcomes in Adults with Haematological Malignancies During Haematopoietic Stem Cell Transplantation.

Background: Gut health is often disrupted in adults with haematological malignancies (HMs) receiving chemotherapy and haematopoietic stem cell transplantation (HCT). Microbial diversity is reduced, and both infection risk and inflammation increased. The role of dietary fibre in enhancing gut health, immune regulation, reducing complications, and improving clinical outcomes for people with HMs shows promise but the extent of their role remains unclear. Objectives: This systematic review evaluated the role of dietary fibre supplementation in adults with HMs undergoing HCT on gut health, immune f

Посттуральный ортостатический синдром тахикардии и ортостатическое гипотезирование после трансплантации стволовых клеток.

СПРАВОЧНИК: Посттуральная ортопедическая тахикардия (POTS) и ортостатическая гипотензия (OH), как правило, происходят после трансплантации стволовых клеток (HSCT). ЦЕЛИ: Данное исследование было направлено на определение распространенности ПОТС и ОЖ до ХОСТ и числа новых случаев после ХОСТ. МЕТОДЫ: В этом одном центре перспективного исследования была проведена оценка пациентов. 30 за несколько дней до 30 и 100 Через несколько дней после HSCT. Кровяное давление, сердечный ритм и уровень плазменного норепинефрина измерялись в суперном положении и после 10-minute испытание активного стенда для оц

Ixazomib, lenalidomide, and dexamethasone in patients with newly diagnosed multiple myeloma: long-term follow-up including ixazomib maintenance.

Triplet combinations containing a proteasome inhibitor are a standard of care in newly diagnosed multiple myeloma (NDMM). We examined the long-term efficacy and safety of the all-oral combination of weekly ixazomib plus lenalidomide-dexamethasone (IRd), followed by single-agent ixazomib maintenance in NDMM patients. Of 65 enrolled patients, 53 received ixazomib 4 mg (days 1, 8, and 15) plus lenalidomide 25 mg (days 1-21) and dexamethasone 40 mg (days 1, 8, 15, and 22) for up to twelve 28-day induction cycles. Twenty-three patients discontinued induction for stem cell transplantation (SCT). In